Unknown Individual – Psychiatry Physician, NPI 1407947443

Unknown Individual is a healthcare provider. based in Hampton, Virginia. specializing in Psychiatry Physician. They hold a License No. 0101042275 (VA). The NPI Number for Unknown Individual is 1407947443

Main info

Organization
Inactive
46 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1407947443
Phone
(757) 826-7516
Address
2112 HARTFORD RD
Deactivation Date
31 July 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8048267516
Graduation Year
1980 (46 years ago)
PAC ID
1759333412
Group Practice PAC ID
9133113996
Professional Enrollment ID
I20050210000895
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 2112, Hartford Road, Hampton City, Virginia, 23666, United States

    HAMPTON, VA 236662409

    Phone: (757) 826-7516

    Fax: (757) 826-6232

    Type: Location

  • 2208, Executive Drive, Hampton City, Virginia, 23666, United States

    SUITE C

    HAMPTON, VA 236666603

    Phone: (757) 826-7516

    Fax: (757) 826-6232

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99214Established patient office or other outpatient visit, 30-39 minutes460151$0
99213Established patient office or other outpatient visit, 20-29 minutes7448$0
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Insurance plans in this area (ZIP 23666)

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Provider's Procedures

Unknown Individual performs procedures in Psychiatry Physician. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PSYCHIATRYVA90792Psychiatric diagnostic evaluation with medical services2222

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9133113996View full group profile
NameSpecialtyState
Nurse PractitionerVA
Mental Health CounselorVA
Nurse PractitionerVA
P S Y C H I A T R YVA
Nurse PractitionerVA
Nurse PractitionerVA
-VA
-VA
Clinical Social WorkerVA
-VA

Reviews

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Frequently asked questions

Does Unknown Individual have a public NPI I can cite?
Public records show Unknown Individual under NPI 1407947443.
What happens when Unknown Individual's NPI is not active?
Public data lists Unknown Individual outside the active bucket for this identifier.
What services align with Unknown Individual's listing?
Unknown Individual's public classification highlights Psychiatry Physician. Clinical services aligned with this taxonomy classification.
What geographic area is tied to Unknown Individual?
Unknown Individual is associated with Hampton, Virginia in the same public data insurers reference.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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